Provider Demographics
NPI:1306110796
Name:GROARKE, LORNE MARY (MD)
Entity type:Individual
Prefix:DR
First Name:LORNE
Middle Name:MARY
Last Name:GROARKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1534
Mailing Address - Country:US
Mailing Address - Phone:631-261-1068
Mailing Address - Fax:631-261-1068
Practice Address - Street 1:96 JAMES ST
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-1534
Practice Address - Country:US
Practice Address - Phone:631-261-1068
Practice Address - Fax:631-261-1068
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125084-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics